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Fact Sheet – Skin Cancer 2010
The Cancer Association of South Africa (CANSA) in urging all South Africans
to be SunSmart to reduce the high incidence of skin cancer in the country.
Skin cancer is the most common cancer in South Africa with about 20 000
reported cases every year and 700 deaths. The World Health Organization
(WHO) reports that between two and three million non-melanoma skin
cancers and approximately 132 000 malignant melanomas occur globally
every year.
South Africa has the second highest incidence of skin cancer in the world
after Australia. The good news is that skin cancer can be prevented by
respecting the sun. The three most common types of skin cancers are basal
cell carcinoma (BCC), squamous cell carcinoma (SCC) and malignant
melanoma.
A significant part of a person‟s lifetime exposure occurs before the age of 18.
Overexposure to ultraviolet radiation can also lead to inflammation of the
cornea and conjunctiva of the eye, and may cause and accelerate the
development of cataracts.
What does a sun protection factor (SPF) mean?
It refers to the extra protection offered by applying a specific sunscreen lotion
to the skin. If your skin usually starts to change colour within five minutes, a
sunscreen with a Sun Protection Factor (SPF) of 20 protects your skin for 20
times as long, i.e. 5 times 20, which equals 100 minutes. Remember, there is
no such thing as a „complete‟ sun-blocker, as all sunscreen lotions need to be
reapplied at regular intervals.
What does UV mean?
Ultra violet (UV) rays are part of the light spectrum that reaches the earth.
There are two kinds of UV rays that damage our skin. The broader UVB rays
cause the browning reaction that we call „tanning‟ and are responsible for the
redness of skin, painful burning, skin damage and skin spots and ultimately
skin cancer.
UVA rays penetrate deeper into the skin and can damage the structure of the
cells, causing ageing, as well as increasing the risk of skin cancer – it is
currently accepted that UVA rays are the cause of malignant melanoma.
Owing to the hole in the ozone layer (known to protect the earth from the sun),
South Africa is receiving increased amounts of UVA and UVB rays from the
sun.
All CANSA Seal of Recognition (CSOR) sunscreens must have broad
spectrum protection abilities, meaning they must protect against ultraviolet A
rays (UVA) and ultraviolet B rays (UVB).
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CANSA Seal of Recognition (CSOR)
The CSOR seal appears on sunscreen products, clothing, swimwear, hats or
sunglasses and is your guarantee that the manufacturers of these UV
protective products have complied with a strict set of criteria developed by
CANSA in the interest of a SunSmart South Africa. Products have to comply
with the South African Sunscreen Standard (SANS) 1557:2009 and/ or the
Australian/New Zealand standard for fabrics, to qualify for the CANSA Seal.
CANSA is currently using two sunscreen testing laboratories in South Africa to
test and validate all sunscreens with the CSOR. Their testing methods and
criteria are aligned to the recognised international standards and protocols.
An international working committee that includes South African
representation, is presently developing an international (ISO) standard to rate
all UV protection levels for sunscreen.
High Risk Exposure
Everyone is at risk of getting skin cancer, although people with darker skins
are less susceptible because their skin contains more natural melanin that
protects against sun damage. People with fair skin, especially those with red
hair, moles or skin spots, as well as people with a personal or family history of
skin cancer, or who play sport outdoors, work in the sun or spend a lot of time
driving, are considered high-risk.
At least 80% of sun-induced skin damage occurs before the age of 18 and
only manifests later in life. Therefore it is imperative to take special care of
children in the sun, whether it is at the pool, on the beach, at play or at school.
Babies younger than one year should never be exposed to direct sunlight.
When it comes to protecting the young ones, mothers of babies and toddlers;
educators and caregivers can play an important role.
Sunbeds and tanning booths are not safe
There is also no such thing as a healthy tan! CANSA has recommended that
the Department of Health ban sunbeds and sunlamps as it has been proven
through recent research findings that there is a relationship between the use
of sunbeds and malignant melanoma, as well as other non-melanoma skin
cancers. Sunbeds predominantly emit UVA and UVB both which can cause
damage in the DNA of skin cells.
Sunbeds and tanning booths deliver concentrated UVA radiation to
unprotected skin and should be avoided at all costs, as it ages skin more
rapidly, while putting you at risk of developing skin cancer. According to
Professor Werner Sinclair, a dermatologist associated with the University of
the Free State: “In general, one can state that the use of an artificial tanning
booth will double the melanoma risk of any particular individual.”
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Spot the Spot
Check your skin carefully every month and ask a family member or friend to
examine your back and the top of your head. If you notice any of the warning
signs, see a doctor or dermatologist immediately.
Warning signs
A-symmetry - a mole or mark with one half unlike the other - common moles
are round and symmetrical
B-order irregularities - scalloped or poorly defined edges - common moles
have smooth and even borders
C-olour variations and inconsistency – tan, brown, black, red, white and blue common moles are usually a single shade of brown or black
D-iameter - larger than 6 mm
Major kinds of skin cancer
There are three (3) major types:
Basal Cell Carcinoma and Squamous Cell Carcinoma are common skin
cancers. The most dangerous skin cancer is Melanoma. Left untreated skin
cancer can lead to death.
 Basal Cell Carcinoma
Raised, translucent, pearly nodules that may crust, ulcerate and
sometimes bleed. Occurs most often on the face and other exposed areas,
but can appear anywhere.
 Squamous Cell Carcinoma
Usually raised, pink opaque nodules or patches that frequently form ulcers
or sores in the centre. Appears most often on exposed areas of the body.
 Malignant Melanoma
Often, small, brown or black, or larger multi-coloured patches with an
irregular outline which may crust and bleed. Malignant melanoma may
occur in pre-existing moles or skin spots. They can also appear like
freckles from previously normal skin.
To prevent skin cancer, CANSA advocates the following:
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Avoid direct sunlight between 10:00 and 15:00 when the sun‟s rays are
most dangerous. Stay in the shade or under an umbrella as much as
possible.
UV rays reflect off cement, water, sand, glass and grass and can
therefore cause sunburn in the shade. UV rays are not the same as
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heat. You can get overexposed even in cool weather - so take care on
windy or overcast days.
Cover up by wearing thickly-woven hats with wide brims and loosefitting clothes, made of tightly-woven, fabric that is cool, but will block
out harmful UV rays. Look out for UV protective swimsuits and beach
wear as UV radiation can penetrate fabric. Swimwear and umbrellas
bearing the CANSA Seal of Recognition should also be part of your
protection kit.
Always apply sunscreen with a Sun Protection Factor (SPF) of a
minimum of 20 and not higher than 50, to all exposed skin areas,
preferably one bearing the CANSA Seal. Re-apply regularly (at least
every two hours), after towel-drying, perspiring or swimming. Apply it
liberally to all exposed skin; including the back of the neck, tips of ears,
arms, feet and hands. The use of sunscreen lotion is not a license to
“bare all” in the sun. Go under cover whenever possible, to ensure that
you are SunSmart while out in the sun.
Protect your eyes by wearing sunglasses with a UV protection rating of
UV400.
Use lip balm with a minimum of SPF 20 and apply regularly.
Avoid sunlamps and tanning parlours.
Take special care to protect children - babies younger than one year
should never be exposed to direct sunlight.
Check your skin regularly for changes, unusual marks or moles. An
annual medical examination should include a skin check. Ask a friend
to check your back and the back of your legs for spots or changes you
may not notice yourself.
CANSA‟s SunSmart campaign takes place during the summer months
(November to February) and includes talks and exhibitions, as well as visits to
schools, holiday resorts and beaches in South Africa.
For more information, contact the CANSA toll-free Information Centre on
0800 22 66 22 or email info@cansa.org.za